Clinical efficacy of bortezomib-based chemotherapy treating relapsed or refractory multiple myeloma

doi:10.3760/cma.j.issn.1673-4777.2014.11.020

Abstract：Objective To examine the recent clinical efficacy and safety of bortezomib-based chemotherapy treating replapsed or refractory multiple myeloma(RRMM).Methods Forty-five patients with RRMM receiving Bortezomib-based regimen treatment from January 2009 to December 2012 were analyzed retrospectively.25 cases were male; 20 were female; age ranged between 37 and 78 years with a mean of(57 ± 2).Fifteen patients were treated with PAD regimen (Bortezomib,adriamycin,dexamethasone).Fifteen patients were treated with PCD (Bortezomib,CTX,dexamethasone).Eight patients received PD regimen (Bortezomib,dexamethasone).Seven patients received PDT (Bortezomib,thalidomide,dexamethasone) ; every patient received 6-8 cycles of chemotherapy.The efficacy was evaluated according to the criteria of European Group for Blood and Marrow Transplanatation.Adverse events were graded according to the criteria of WHO.Results The median follow-up time was 25 months (5-35).15 patients were treated with PAD chemotherapy regimens; the effective rate was 93.3％ (14/15).The complete response (CR) /the near complete response (nCR) was 46.7％ (7/15) ; the very good complete response (VGPR) was 20％ (3/15) ; the partial response (PR) was 13.3％ (2/15) ; the minor response (MR) was 13.3％ (2/15) ; SD was 6.7％ (1/15).15 patients were treated by PCD chemnotherapy regimens; the effective rate was 93.3％ (14/15).The complete response(CR) /the near complete response(nCR) was 46.7％ (7/15) ;the very good complete response (VGPR) was 20％ (3/15) ; the partial response (PR) was 20％ (3/15) ; the minor response (MR) was 6.7％ (1/15) ; SD was 6.7％ (1/15).There was no statistical significance in two difference groups regarding PAD and PCD(P ＞ 0.05).8 patients were treated by PD and the effective rate was 75％ (6/8).The complete response(CR) /the near complete response(nCR) was 37.5％ (3/8) ; the very good complete response (VGPR) was 12.5％ (1/8) ; the partial response (PR) was12.5％ (1/8) ; the minor response (MR) was 12.5％ (1/8) ; SD was 1 2.5％ (1/8).7 patients were treated by PTD chemotherapy regimens; the effective rate was 85.7％ (7/8).The complete response (CR) /the near complete response (nCR) was 28.6％ (2/7) ; the very good complete response (VGPR) was 14.3％ (1/7) ; the partial response (PR) was 14.3％ (1/7) ; the minor response (MR) was 14.3％ (1/7) ; SD was 14.3％ (1/7).There was no statistical significance in two difference groups by PD and PTD (P ＞ 0.05).6 cases had limbs numbness because of Bortezomib.The major adverse events during treatment were peripheral neuropathy,gastrointestinal disorder,herpes zoster and infection,hematology toxicity,fatigue and baldness.These side effects could be controlled by adjusting drug doses,drug withdrawal or symptomatic treatment.Conclusions Bortezomib based chemotherapy is well tolerated and is an effective regimen in treatment of RRMM.The adverse effects are predictable and manageable.